Anxiety disorders strategies

Buspirone. Although initial open label results were promising, a controlled study of buspirone, approved by the FDA for treatment of GAD, failed to demonstrate any effectiveness in the treatment of social anxiety disorder. However, a subsequent controlled study indicated that buspirone administered at 30-60 mg/day is an effective augmentation strategy for patients with social anxiety disorder who have only experienced a partial response to SSRI therapy. 

Specific Sociai Anxiety Disorder, Acute Phase Treatment. Different strategies have evolved for treating specific social anxiety disorder versus generalized social anxiety disorder. Less complicated is the management of the specific subtype. Exposure-based psychotherapy is a mainstay of treatment, and as-needed medication doses prior to scheduled performances are also widely used. Preferred agents for performance anxiety are alprazolam or propranolol. 

The family study approach, particularly when employed with systematic community-based samples, is one of the most powerful strategies to minimize heterogeneity, since etiologic factors for the development of a particular disorder can be assumed to be relatively homotypic within famihes. There is a dearth of studies that have employed within-family designs to examine either phenotypic expression or some of the putative biologic factors underlying the major anxiety disorders. For example,both Perna et al. (1996,1995) and Coryell... 

There are several strategies for helping adolescents with anxiety disorders. Although medications can be effective to help control anxiety symptoms, they are not a long-term solution. Instead, it is recommended that therapists and physicians help the affected teens learn how to control their anxiety. 

Perhaps the most commonly used example of the serotonin 2A strategy is the combination of an SSRI with trazodone. Clinicians have long recognized that trazodone will improve the agitation and insomnia often associated with SSRIs, allow high doses of the SSRI to be given, and consequently boost the efficacy of the SSRI not only in depression, but also in obsessive-compulsive disorder and other anxiety disorders. Thus, both types of bad math are in play here. 

Several subtypes of depression require specific treatment strategies that go beyond a simple course of conventional antidepressant therapy (these subtypes include bipolar depression, major depression with psychotic features, seasonal depression, atypical depression, comorbid anxiety disorder, comorbid substance abuse, double depression [major depression... 

Pollack MH. Social anxiety disorder Designing a pharmacologic treatment strategy. J Clin Psychiatry 1999 60(Suppl 9) 20-26. 

When dealing with individuals who suffer from the anxiety-related conditions, a physical exam is essential. A physical exam is needed to determine and address the multifaceted symptoms that often coexist in individuals who suffer from the anxiety disorders. For example, it can be difficult to differentiate symptoms related to anxiety from those related to medical conditions such as heart difficulties, asthma, and hypertension. Clear identification of these symptoms is important because these medical conditions can produce anxiety-like symptoms that confuse both the client and the health care professional. Professionals agree that a thorough medical examination is needed to rule out potential physiological difficulties and to assist in preparing for the psychosocial strategies that will follow. 

This chapter presents an overview of the knowledge and skills necessary to treat clients with anxiety disorders, and it encourages social workers to seek additional information on these disorders and their treatments. Given the rapidly changing health and mental health practice environments, social workers must stay abreast of new trends and therapeutic strategies in the mental health field. 

---